Treatment of Migraine: An Armory of Therapeutic Drugs from Which to Choose

Article excerpt

Mild Episodes of Migraine

Simple analgesics, like aspirin or acetaminophen, may be all that is required for mild episodes of migraine.

For more intense cases of migraine, various nonsteroidal anti-inflammatory drugs (NSAIDs) are usually prescribed:

Indomethacin -- Not recommended for patients with liver disease, ulcers, or other stomach problems. Inform your doctor if you are taking medications to prevent blood clots. Report bloody stools or blurred vision.

Ibuprofen (Motrin, Advil, Nuprin) -- Side effects can include diarrhea, dizziness, constipation, dry mouth, fluid retention, stomach ulcers, damage to the cornea, kidney damage, and reduced white blood cell count. Report other medication use.

Naproxen -- Has risen to prominence in the treatment of migraine because of reported tolerance and record of safety.

Moderate to Severe Episodes of Migraine

Ergotamine -- Ergotamine tartrate has been in use since 1928 (similar formulas are Cafergot, Ergomar, Ergostat Gynergen). Rectal suppositories of ergotamine are available and are more rapidly absorbed. Excessive use of ergotamine can result in cold, clammy extremities (vasoconstriction), chest pain, claudication of legs, and numbness of hands and feet. Inform your doctor immediately of severe abdominal pain. Do not take if you are hypertensive or have a peptic ulcer, kidney disease, or a liver disorder.

Sumatriptan (Imitrex) -- Heralded as the innovation of the decade, sumatriptan is considered a major advance in migraine therapy. Injection preparations are available in the United States. Oral preparations can be procured in some other countries (Canada). Glaxo, the maker of Imitrex, promises availability in the United States by late fall, 1994. …


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